The identification and modification of cardiovascular risk factors of hypertensive disorders in the early stage of pathogenesis, especially before the occurrence of structural changes in the peripheral vasculature, is a national concern. Procedures for early identification should be augmented by interventions which are appropriate to life styles and can be implemented on a scale sufficient to achieve improvements in public health. The objectives of this research are to test the combined and separate cost-effectiveness of psychophysiological and educational-behavioral interventions directed at cardiovascular risk behavior and blood pressure in adolescents, and to examine the cardiovascular correlates of blood pressure changes in adolescents undergoing psychophysiological and educational interventions. A diagnostic-baseline study of cognitive, behavioral, familial, environmental and medical factors associated with elevated blood pressure will be carried out in a cohort of 100 patients referred to the Hopkins Pediatric Blood Pressure Clinic. These patients will then be randomly assigned to one of two treatment groups: (1) a psychophysiological-behavioral series of interventions, or (2) an educational-behavioral series. A crossover design will reassign half of the subjects to the opposite treatment, allowing statistical tests of comparative, combined, and ordering effects and duration of effects on blood pressure control from the two behavioral strategies. In addition, the patients will be closely monitored for evidence of hemodynamic changes corresponding to blood pressure changes on a prospective basis. As additional patients are accumulated in year 2, a second round of intervention trials will be conducted with refinements based on year 1 results. By interfacing the present knowledge base of biomedical, behavioral and public health research, the proposed research will provide an empirical analysis of methods for preventing the development of sustained essential hypertension in young people who show early signs of blood pressure disorder.